Goals - 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

Thank you for providing feedback for the recipient above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Rate each item using the scale shown. If you don't feel you have enough first-hand information to rate a certain item, please choose the Not Applicable option. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the Closing Comments section. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

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Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

Goals	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Conducts timely follow-up; keeps others informed on a need to know basis.
Establishes and documents goals and objectives.
Achieves established goals.
Understands & contributes to development of strategic goals.
Sets high expectations and goals; encourages others to support the organization.
Trustworthy	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Delivers on promises made.
Is trustworthy; is someone I can trust.
Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
Communicates an understanding of the other person's interests, needs and concerns.
Builds and maintains the trust of others.
Partnering/Networking	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Develops a sense of trust in subordinates so they can freely interact and share information with others.
Creates value within the Company by building networks.
Promotes the understanding of how the department affects the organization overall.
Supports a partnering/networking culture.
Forges mutually beneficial relationships between individuals with diverse backgrounds.
Business Acumen	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Understands cash flow procedures and statements.
Can effectively interpret and analyze data.
Considers impact of actions on other areas of the organization.
Aware of regulations that impact our business.
Understands complex issues and problems.
Entrepreneurship	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Maintains a high level of energy to respond to demands of the job.
Takes the initiative to complete tasks.
Devotes a certain amount of time and effort to developing new business opportunities.
Able to adapt the department to changing business demands and climate.
Exhibits determination and passion in completion of goals.
Vision	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Behaves in a way that is consistent with business values & code of conduct
Develops action plans to align his/her work with the goals of the organization
Demonstrates consistency between words and actions
Leads employees in new directions.
Understands the vision of the Company and promotes it ahead of any self-interests.

31. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
32. Strengths
    
    
    
33. Areas for Development
    
    
    
34. Please give any final comments or suggestions for [Participant Name Here]'s assessment.